Diagnosis of Chronic Obstructive Pulmonary Disease (COPD)

COPD cannot be detected before irreversible lung damage has occurred. But, the earlier it is detected, the sooner steps can be taken to modify further damage. Your doctor will ask you about your symptoms and medical history. A physical exam will be done. Your history and physical exam provide the most important information that is used for the diagnosis of COPD.

If your doctor suspects you might have COPD, you may have one or more of the following tests:

Lung Tests

Pulmonary Function Tests

Many tests of lung function have been developed. Each provides slightly different information about how well your lungs are working.
Pulmonary function tests
are painless and noninvasive. They are performed using a machine called a spirometer. By breathing into the spirometer, your doctor can measure your lung volume and your ability to move air in and out of your lungs in a certain period of time. Your results are compared with typical findings of a healthy person your age and height. Your doctor can then determine to what extent your lung function is diminished. Sometimes, tests are repeated after you have been given a bronchodilator medication. This is to see if your results improve with this type of treatment.

Pulmonary function measures include:

Forced Vital Capacity (FVC)
—This is the maximum volume of air that can be forcibly exhaled after inhaling as deeply as possible.

Residual Volume (RV)
—This is the amount of air that remains in the lungs when measuring vital capacity after a maximal exhalation. In persons with COPD, RV is usually increased dramatically from normal because air is trapped in the damaged lung and cannot be exhaled normally.

Total Lung Capacity (TLC)
—This is the total amount of air the lungs are capable of holding. It is the combination of FVC and RV.

Forced Expiratory Volume in 1 Second (FEV
1
)
—This measures the volume of air that can be forcibly exhaled in one second. It represents the rate of air movement out of the lungs. FEV
1
typically declines a very small amount per year in normal persons. But, the decline can be several times greater in people with COPD.

This test measures how well your lungs transfer a small amount of carbon monoxide gas into your blood. You take a breath of air containing a very small amount of carbon monoxide from a container. The amount of carbon monoxide in your exhaled air or arterial blood is then measured.

Other Tests

Oximetry

A sensor on your finger is used. It can quickly get basic information about the amount of oxygen in your blood.

Levels of Alpha-1-Antitrypsin
—This is an important protein that helps protect the lungs from damage due to inflammation. Persons who develop COPD at an early age, or who develop the disease but never smoked, may have abnormally low levels of this protein due to a genetic defect.

Imaging Tests

Imaging tests are used to examine the lungs and evaluate lung damage. These may include:

What is COPD? National Heart, Lung, and Blood Institute (NHLBI) website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/copd. Updated July 31, 2013. Accessed February 24, 2014.

What you can do about a lung disease called COPD. Global Initiative for Chronic Obstructive Lung Disease website. Available at:
http://www.goldcopd.org/uploads/users/files/GOLD%5FPatient%5FRevJan10.pdf. Accessed February 24, 2014.